Abstract
BackgroundLaparoscopic paraesophageal hernia repair is associated with higher recurrence rate. Mesh is used to reduce the recurrence rate. This retrospective study is to review our experience of biological mesh fixed with suture and medical glue in hiatal hernias repairs.MethodsA retrospective chart review was conducted for a consecutive series of patients undergoing laparoscopic hiatal herniorrhaphy between January 2018 and January 2019. After hiatus closure, a piece of biological prosthesis was fixed with medical glue and suture for reinforcement of the crural closure. Clinical outcomes were reviewed, and data were collected regarding operative details, complications, symptoms, and follow-up imaging. Radiological evidence of any size of hiatal hernia was considered to indicate a recurrence.ResultsThirty-six patients underwent surgery uneventfully without any serious complication. There was no mortality. The follow-up was, on average, 18.4 months, and there was no symptomatic recurrence. There was one anatomical recurrence without any related presentation. The method of mesh fixation with medical glue and suture took 12 min on average, and the handling was fairly easy.ConclusionsBiological mesh fixed with suture and medical glue was safe and effective for repairing large hiatal hernias. Of course, a longer follow-up is still needed for determining long-term outcomes.
Highlights
Laparoscopic paraesophageal hernia repair is associated with higher recurrence rate
From January 2018 to January 2019, 36 patients underwent laparoscopic hiatal hernia repair with biological prosthesis fixed by medical glue and suture
Preoperative oesophageal manometry showed that Lower esophageal sphincter pressure (LESP) on average was 6.8 ± 3.6mmHg, and 12 cases were found to have mild motility disorder
Summary
Laparoscopic paraesophageal hernia repair is associated with higher recurrence rate. Mesh is used to reduce the recurrence rate This retrospective study is to review our experience of biological mesh fixed with suture and medical glue in hiatal hernias repairs. Laparoscopic hiatal hernia repair (LHHR) is considered to be the gold standard for the management of hiatal hernias, and is associated with a reduced rate of perioperative morbidity and shorter hospital stay compared with the open approach [1, 2]. Oelschlager et al reported that the recurrence rate after pure suture repair without mesh reinforcement is as high as 59% at 5-year follow-up [4]. Two randomised trials have demonstrated that a significant reduction in recurrence rates can be achieved by using synthetic mesh for large hiatal hernia repair [5, 6]. In order to avoid those complications, Nie et al BMC Surg (2021) 21:158 the surgical technique for reliable mesh fixation has been improved, and the mesh specially designed for hiatal hernia has been improved
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